Article Reviews: Post Traumatic Stress Disorder
Question
Post Traumatic Stress Disorder


Solution
Article Reviews: Post Traumatic Stress
Disorder (PTSD)
Article 1
The first article is by Hageman, Anderson,
and Jorgensen, who review how different pharmacological and psychobiological
interventions are adequate for PTSD expressions. In this case, a substantive
review of the literature searches concluded that PTSD affected the pathways of
opioid, GABAergic, glutamatergic, neuroendocrine, and serotonergic when
evaluating the psychophysiology pathways of PTSD (Hageman et al. 411).
Different medications work for different symptoms of the diseases, including
using selective serotonin reuptake inhibitors, tricyclic antidepressants (TCAs),
both the reversible and irreversible MAO-inhibitors, and the anticonvulsant
lamotrigine (Hageman et al. 412). Based on these findings, the authors make
various suggestions, especially on the levels of the pharmacotherapy based on
the type of symptoms and severity of the PTSD conditions, including comparing
if the individual was involved in combat or not. In this case, the authors
recommend that antidepressants that are classified as the selective serotonin
reuptake inhibitors (SSRIs) are the first line of treatment in the core PTSD
symptoms because of the efficacy in the three major symptom clusters of the
disease than any of the drugs for numbing and avoidance clusters (Hageman et
al. 419). The second line includes the TCAs, which are effective, especially in
treating and ameliorating the anxiety and depressive symptoms that are
intrusive for PTSD patients (Hageman et al. 419). These also have little effect
on the numbing and avoidance symptoms. The MAO-inhibitors are considered the
third line of treatment choice due to the additional elements of TCAs,
including helping patients that take alcohol to reduce the alcohol and
potential adverse effects associated with drug abuse (Hageman et al. 419).
These authors mostly use the literature
review approach to reach their conclusions based on interrogating how various
medications respond to various expressions of the PTSD symptoms. The analysis
is based on the dysregulation of some of the psychological pathways affected by
PTSD and how various pharmacology interventions focusing on various types of medicines
respond to the symptoms arising from particular pathways to recommend the most
effective drugs. However, PTSD involves the psychological and neurological
responses and the mind. In this case, the authors could have also considered
the impact of non-pharmacological interventions, including psychotherapists and
clinical counseling, over time that help the victims overcome or learn to
manage the stressors. Therefore, more research questions could arise in
comparing the effectiveness of the pharmacotherapies compared to the
non-pharmacological interventions.
Article 2
The second article is by Richard Bryant,
which focuses on the review of PTSD condition and how various definitions have
led to differences in the type of response to the patients with the condition.
First, Bryant recognizes that most patients with the PTSD condition express the
symptoms because of exposure to a traumatic event which is a stress trigger to
the condition (259). In this case, Bryant indicates that there are two main
approaches to defining the condition of PTSD based on the DSM-5 and ICD-11
disagreement (260). On one end, PTSD is defined as including the construct of
the diseases resulting from the psychological manifestation a patient
experiences after exposure to the traumatic experiences. However, other
definitions are centered on the idea that the construct of PTSD is based on the
memory phenomena of the brain and neurological pathways affected that arise
after trauma. Bryant claims that the impact of these differences limits the effective
identification of appropriate biomarkers of the diseases and the specific
mechanisms that lead to the development of traumatic stress (263). Therefore,
the author review literature on the evidence-based interventions and concludes
that only two-thirds of the patients have responded well to the cognitive
behavioral therapy that is most preferred for PTSD patients (Bryant 265).
Therefore, seeking a combination of cognitive-behavioral therapy and
pharmacological therapy can enhance the disease’s practical outcomes and help
overcome some barriers, such as the lack of access to such evidence-based
treatment in low and middle-income countries (Bryant 269).
The authors mostly interrogate literature to
explore various foundations for interventions for PTSD disease. This includes
exploring the effectiveness of the cognitive-behavioral approach compared to
pharmacological interventions through drugs targeting the memory. However, the
author advances the need to consider recent evidence-based treatments such as a
combination of the two and focus on specific symptoms of the patient for
effective outcomes. There could be more research on how the two combinations
work together and what interventions are best for particular symptoms. This is
because the nature of the traumatic experience and the symptoms that patients
show differ.
Article 3
The last article is by Robert Fenster and
other authors that focus on the most recent developments in understanding the
impact of PTSD on brain dysfunction and alternative treatments that have been
effective in the recent past. In this case, the authors claim that PTSD is
becoming a prevalent disease for many people and sometimes could be severe to
the extent of causing severe psychological trauma to an individual (Fenster et
al. 535). Most of the focus in the recent past has been on treatments using
antidepressants, and cognitive behavioral therapy, which the authors claim are
limited (Fenster et al. 535). Based on this assumption, the authors then
indicated that new approaches enhance the prevention and treatment of PTSD
symptoms based on recent evidence-based research on the underlying PTSD
dysfunctional brain circuits (Fenster et al. 535). This research, aided by
recent advanced technologies, has enabled researchers to map out the macrocircuits
and microcircuits related to particular PTSD symptoms; hence, developing
treatments focusing on such pathways could better manage risk and enhance
resilience as a new therapeutic discovery.
Considering these are new advancements,
there still needs to be intensive research, especially building on the previous
interventions for PTSD, including the cognitive and behavioral therapies and
how specific medication responds to particular symptoms. The main aim is to
enhance how recent developments and past interventions can effectively improve
patient health outcomes and manage stressors.
Works Cited
Bryant,
Richard A. “Post‐Traumatic Stress Disorder: A State‐Of‐The‐Art Review Of
Evidence And Challenges.” World Psychiatry, vol 18, no. 3, 2019, pp. 259-269.
Wiley, https://doi.org/10.1002/wps.20656. Accessed 26 May 2022.
Fenster,
Robert J. et al. “Brain Circuit Dysfunction In Post-Traumatic Stress Disorder:
From Mouse To Man.” Nature Reviews Neuroscience, vol 19, no. 9, 2018, pp.
535-551. Springer Science And Business Media LLC,
https://doi.org/10.1038/s41583-018-0039-7. Accessed 26 May 2022.
Hageman,
I. et al. “Post-Traumatic Stress Disorder: A Review Of Psychobiology And Pharmacotherapy.”
Acta Psychiatrica Scandinavica, vol 104, no. 6, 2001, pp. 411-422. Wiley,
https://doi.org/10.1034/j.1600-0447.2001.00237.x.



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